Bootstrap 3 Full Registration form

bs3-registration-form.html

<div class="col-xs-12 col-sm-8 col-md-4 col-sm-offset-2 col-md-offset-4">
    <form role="form">
        <div class="row">
            <div class="col-xs-4 col-sm-4 col-md-4">
                <div class="form-group">
                    <select name="" id="" class="form-control input-sm">
                        <option value="mr">Mr.</option>
                        <option value="mrs">Mrs.</option>
                        <option value="miss">Miss</option>
                        <option value="ms">Ms.</option>
                        <option value="dr">Dr.</option>
                        <option value="rev">Rev.</option>
                        <option value="fr">Fr.</option>
                    </select>
                </div>
            </div>
            <div class="col-xs-4 col-sm-4 col-md-4">
                <div class="form-group">
                    <input type="text" name="firstName" id="firstName" class="form-control input-sm" placeholder="First Name">
                </div>
            </div>
            <div class="col-xs-4 col-sm-4 col-md-4">
                <div class="form-group">
                    <input type="text" name="lastName" id="lastName" class="form-control input-sm" placeholder="Last Name">
                </div>
            </div>
        </div>
        <div class="row">
            <div class="col-xs-6 col-sm-6 col-md-6">
                <div class="form-group">
                    <input type="text" name="address" id="address" class="form-control input-sm" placeholder="Street Address">
                </div>
            </div>
            <div class="col-xs-6 col-sm-6 col-md-6">
                <div class="form-group">
                    <input type="text" name="addressLineTwo" id="addressLineTwo" class="form-control input-sm" placeholder="Address Line 2">
                </div>
            </div>
        </div>
        <div class="row">
            <div class="col-xs-4 col-sm-4 col-md-4">
                <div class="form-group">
                    <input type="text" name="city" id="city" class="form-control input-sm" placeholder="City">
                </div>
            </div>
            <div class="col-xs-4 col-sm-4 col-md-4">
                <div class="form-group">
                    <select name="" id="" class="form-control input-sm">
                        <option value="AL">AL</option>
                        <option value="AK">AK</option>
                        <option value="AZ">AZ</option>
                        <option value="AR">AR</option>
                        <option value="CA">CA</option>
                        <option value="CO">CO</option>
                        <option value="CT">CT</option>
                        <option value="DE">DE</option>
                        <option value="DC">DC</option>
                        <option value="FL">FL</option>
                        <option value="GA">GA</option>
                        <option value="HI">HI</option>
                        <option value="ID">ID</option>
                        <option value="IL">IL</option>
                        <option value="IN">IN</option>
                        <option value="IA">IA</option>
                        <option value="KS">KS</option>
                        <option value="KY">KY</option>
                        <option value="LA">LA</option>
                        <option value="ME">ME</option>
                        <option value="MD">MD</option>
                        <option value="MA">MA</option>
                        <option value="MI">MI</option>
                        <option value="MN">MN</option>
                        <option value="MS">MS</option>
                        <option value="MO">MO</option>
                        <option value="MT">MT</option>
                        <option value="NE">NE</option>
                        <option value="NV">NV</option>
                        <option value="NH">NH</option>
                        <option value="NJ">NJ</option>
                        <option value="NM">NM</option>
                        <option value="NY">NY</option>
                        <option value="NC">NC</option>
                        <option value="ND">ND</option>
                        <option value="OH">OH</option>
                        <option value="OK">OK</option>
                        <option value="OR">OR</option>
                        <option value="PA">PA</option>
                        <option value="RI">RI</option>
                        <option value="SC">SC</option>
                        <option value="SD">SD</option>
                        <option value="TN">TN</option>
                        <option value="TX">TX</option>
                        <option value="UT">UT</option>
                        <option value="VT">VT</option>
                        <option value="VA">VA</option>
                        <option value="WA">WA</option>
                        <option value="WV">WV</option>
                        <option value="WI">WI</option>
                        <option value="WY">WY</option>
                    </select>
                </div>
            </div>
            <div class="col-xs-4 col-sm-4 col-md-4">
                <div class="form-group">
                    <input type="text" name="zipcode" id="zipcode" class="form-control input-sm" placeholder="Zipcode">
                </div>
            </div>
        </div>
        <div class="row">
            <div class="col-xs-6 col-sm-6 col-md-6">
                <div class="form-group">
                    <input type="text" name="dayPhoneNum" id="dayPhoneNum" class="form-control input-sm" placeholder="Daytime phone number">
                </div>
            </div>
            <div class="col-xs-6 col-sm-6 col-md-6">
                <div class="form-group">
                    <input type="text" name="eveningPhoneNum" id="eveningPhoneNum" class="form-control input-sm" placeholder="Evening phone number">
                </div>
            </div>
        </div>
        <div class="row">
            <div class="col-xs-6 col-sm-6 col-md-6">
                <div class="form-group">
                    <input type="email" name="email" id="email" class="form-control input-sm" placeholder="Your email address">
                </div>
                <div class="form-group">
                    <input type="email" name="emailConfirm" id="emailConfirm" class="form-control input-sm" placeholder="Please re-enter your email address">
                </div>
            </div>
        </div>
        <div class="row">
            <div class="col-xs-6 col-sm-6 col-md-6">
                <div class="form-group">
                    <input type="password" name="password" id="password" class="form-control input-sm" placeholder="Password">
                </div>
            </div>
            <div class="col-xs-6 col-sm-6 col-md-6">
                <div class="form-group">
                    <input type="password" name="passwordConfirm" id="passwordConfirm" class="form-control input-sm" placeholder="Re-enter password">
                </div>
            </div>
        </div>
        <input type="submit" value="Register" class="btn btn-info btn-block">
    </form>
</div>